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Child abuse can often be very difficult to identify. This is especially true in cases of abuse by suffocation. Suffocation often leaves no external physical marks and presents with vague, nonspecific symptoms. Infants who have been suffocated usually present unexplained apnea, cyanosis, or seizure. Moreover, new-onset seizures can be mistaken for an organic seizure disorder. This case report reviews a case of abuse by suffocation, which presented as new-onset status epilepticus. This case illustrates that suffocation can be difficult to diagnose despite the recognition of red flags that should prompt an investigation for abuse.

From the *Child Protection Program, University of Iowa, Iowa City, IA; †Department of Pediatrics, Ege University, Izmir, Turkey; and ‡Division of Pediatric Radiology, Department of Radiology, University of Iowa, Iowa City, IA.